Central Thalamic Deep Brain Stimulation Modulates Autonomic Nervous System Responsiveness in Disorders of Consciousness

Background: The heart rate variability (HRV) of patients with disorders of consciousness (DOC) differs from healthy individuals. However, there is rarely research on HRV among DOC patients following treatment with deep brain stimulation (DBS). This study aims to investigate the modulatory effects of DBS-on the central-autonomic nervous system of DOC based on the study of HRV variations. Methods: We conducted DBS surgery on eight patients with DOC. Postoperatively, all patients underwent short-duration stimulation for 3 days, with stimulation frequencies of 25 Hz, 50 Hz, and 100 Hz respectively. Each day comprised four cycles, with a stimulation duration of 30 min DBS-on and 90 min DBS-off. We obtained the coma recovery scale-revised (CRS-R) scores and synchronously recorded electrocardiographic data. Resulits: We analyzed the HRV indices, including time-domain and frequency-domain parameters across various time points for all patients. The HRV exhibited a consistent trend across the three groups with different parameters. Notably, the most pronounced HRV changes were induced by the 100 Hz. Long-term follow-up indicates that high-frequency (HF), low-frequency (LF), and total power (TP) of HRV may serve as predictive indicators in the prognosis of patients. Conclusion: Our study reveals that DBS enhances DOC patient consciousness while increasing HRV. Specifically, frequency-domain indices correlate with favorable prognosis.